Can someone explain more about hormone therapy for before and after tummy tuck, liposuction, etc.?

Question

I've been seeing a lot of posts in a Q&A section of the site regarding hormone therapy for before and after cosmetic surgery. What is that all about? Are there any resources that you can share?

Daniel Barrett, MD · Answer

Dear besos4all,,
every plastic surgeon has his own postoperative protocol which he recommends to his patients. Most plastic surgeons will ask their patients to stop taking hormones prior to surgery. I would suggest you to discuss this with your plastic surgeon.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Kenneth Hughes, MD · Answer

Use of birth control pills or hormone replacement therapy increases the risk of blood clots and typically patients are advised to stop taking these one month prior to liposuction.
Because vaginal estrogens fall into the general category of estrogen therapies, there is some controversy in their safety before surgery. Premarin vaginal cream only produces a localized effect so very little is absorbed into the bloodstream. Therefore it is less likely to cause the unwanted side effects associated with oral hormone replacement therapy. 
If the patient has an IUD with a hormonal component, removal may be considered to reduce the risk for venous clots. This should be considered on a case by case basis. You will need to clear this with the board certified plastic surgeon who performs your BBL and your gynecologist.

Camille Cash, MD · Answer

Your safety is always the number one priority during surgery.  Hormone replacement therapy, including birth control pills, are associated with increased risk of blood clot formation during a tummy tuck.  For this reason your surgeon may ask you to stop taking these medications prior to surgery.  It is important to review all medications you take including prescription, non prescription, and supplements.  Your surgeon will advise which, if any need to be stopped prior to surgery.

Mats Hagstrom, MD (license on probation) · Answer

Personally I think hormone therapy should be left up to the endocrinologist. For most people when they take supplemental hormones the pituitary gland adjusts the natural production to compensate for what’s being taken and in the end patient simply becomes reliant on the supplement hormone.

There are risks with taking hormone supplements and potential benefits especially for those who are lacking normal hormone levels.

I don’t think this is something plastic surgeons, dermatologist or anybody other than endocrinologist shouldn’t  be doing.

It is not within the mainstay of plastic surgery and the great majority of plastic surgeons do not engage in hormone replacement therapy.

I think you’ll find this more likely in the “want to be plastic surgery” group of doctors engaging in aesthetic medicine for cash only clan. A lot of this work lacks Scientific validity and is not evidence-based medicine.

Talk to your primary care doctor to see if an endocrinology consultation is indicated in your case.

Best,

Mats Hagstrom MD

Richard P. Rand, MD, FACS (retired) · Answer

Geberally patients are asked to stop hormone treatments because they can increase the risk of DVT which can lead possibly to pulmonary embolism (PE) and death.

Can someone explain more about hormone therapy for before and after tummy tuck, liposuction, etc.?

Answers (5)

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